Assisted Outpatient Treatment

Consistent with Mental Hygiene Law 9.60 (Kendra’s Law), under the oversight of the Director of Community Services, Niagara County operates a program that provides Assisted Outpatient Treatment (AOT). Enhanced monitored comprehensive behavioral health services are provided to individuals with a mental illness who, in view of their treatment history and present circumstances are unlikely to survive safely in the community without supervision.

AOT Eligibility:

A person may be eligible to obtain AOT if he or she:

Is at least 18 year of age and is diagnosed with a mental illness; and

Is unlikely to survive in the community without supervision, based on a clinical determination; and

Has a history of non-compliance with treatment for mental illness which has led to:
Either 2 hospitalizations for mental illness in the preceding 3 years, or
Incarceration during which psychiatric treatment was provided, or
At least 1 act of violence toward self or others, or threats of serious physical harm to self or others, within the preceding 4 years; and

Is unlikely to accept the treatment recommended in the treatment plan; and

Is in need of AOT to avoid a relapse or deterioration that would likely result in serious harm to self or others; and

Will likely benefit from AOT.

Frequently Asked Questions

How do I refer someone to the AOT Program?

Contact the Niagara County Department of Mental Health AOT Program at 439-7412. A staff member will respond to your concerns and questions while gathering information from you about your referral.

Eligibility may be determined during the telephone screening or further investigation may be needed. If an individual does not meet AOT criteria, referral to other appropriate services will be offered.

What happens after the initial phone call?

A certified social worker will begin an investigation through contacts with the individual, the individual’s family members and his/her service providers. The social worker will also gather treatment records from previous and current service providers.

How does the AOT Program help an individual comply with outpatient treatment?

The social worker will work with each individual to achieve and maintain stability and increase life quality through linkage with the most effective and least restrictive services available. The social worker will work with the individual to develop an individualized treatment plan and a written contract. Services may include some or all of the following: mental health treatment, drug and alcohol abuse treatment, hospital in-patient or day treatment, structured housing, case management, vocational programming and crisis services.

How long does an individual remain in the AOT program?

An individual will remain in active status in the program until they have demonstrated clear stability and compliance with the treatment plan for an extended period of time. After that, the individual may move into inactive status, and a low level of monitoring. After long term compliance with treatment, the AOT case may be closed.

What happens if the individual does not comply with AOT assistance?

After diligent efforts have been exhausted and an individual remains at risk of self-harm or harm to others, a petition for an AOT court order may be initiated with the state supreme court system to ensure safety and treatment compliance. The petition, which is a formal statement of facts demonstrating that the person meets the criteria for AOT, must be accompanied by the affidavit of an examining physician. The affidavit must show that the physician examined the person and, with the individual, developed a treatment plan, prior to the filing of the petition, and that the individual meets the programmatic criteria.

To whom is the court order directed?

The court order is directed to both the individual receiving AOT and the local director of the AOT program. The order will require the individual to accept the treatment deemed necessary by the court, and will require the local director to furnish such treatment through local service providers. This provides greater accountability of service providers in serving the consumer.

How long does the AOT court order remain in effect?

The initial court order is effective for up to 6 months from the date of the order. The order can be extended for successive periods of up to 1 year each, but any application to extend AOT requires a showing that the person continues to meet all of the AOT criteria.

Additional Consumer Services

Consumers have the opportunity access legal representation throughout their involvement with the AOT program from Mental Hygiene Legal Services.

In order to ensure personal choices regarding mental and physical care, if one becomes incapable of making treatment decision, one may wish to document preferences in an Advance Directive. More information about Advance Directives can be obtained by contacting Mental Hygiene Legal Services at 874-7532.

To enlist the help of a peer, contact the Mental Health Association at 433-3780.